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振幅整合脑电图在新生儿缺氧缺血性脑病早期诊断及预后预测中的价值

Value of amplitude-integrated electroencephalograph in early diagnosis and prognosis prediction of neonatal hypoxic-ischemic encephalopathy.

作者信息

Yin Xiao-Juan, Wei Wei, Han Tao, Shang Ming-Xia, Han Xiao, Chai Yan-Nan, Feng Zhi-Chun

机构信息

Affiliated Bayi Children's Hospital, Beijing Military Region General Hospital No. 5 Nan Mencang, Dongcheng District, Beijing 100700, China.

出版信息

Int J Clin Exp Med. 2014 Apr 15;7(4):1099-104. eCollection 2014.

Abstract

UNLABELLED

To investigate value of amplitude-integrated electroencephalograph (aEEG) in early diagnosis and prediction of long-term prognosis of neonatal hypoxic-ischemic encephalopathy (HIE), 120 HIE Children were randomly assigned into aEEG group and control group (n = 60 per group). Children in each group were sub-divided into mild, moderate and severe HIE groups (n = 20 per group). 1, 3, 14 and 28 days after birth, aEEG was performed in aEEG group; 3, 14 and 28 days after birth, neonatal behavioral neurological assessment (NBNA) was done in both groups. Children who discharged were followed up at adjusted gestational age of 12 months with Denver Developmental Screening Test (DDST) and prognosis evaluation.

RESULTS

aEEG manifestation was positively related to clinical severityb of HIE (r = 0.843, P < 0.01). On day 3 and 14, NBNA score was comparable between two groups (P > 0.05), but significant difference in NBNA score was noted on day 28 (P < 0.05). On day 3, 14 and 28, aEEG manifestation was positively associated with prognosis at adjusted gestational age of 12 months (r = 0.832, 0.857, 0.778, 0.743, P < 0.01). In aEEG group, disability rate was 13.8%, which was significantly lower than that in control group (23.2%); cure rate in aEEG group (60%) was significantly higher than that in control group (40%). Moreover, long-term prognosis was also dramatically different between aEEG group and control group (χ(2) = 4.107, P < 0.05).

CONCLUSION

aEEG manifestation is significantly associated with clinical severity of HIE and may be helpful for early diagnosis of HIE. aEEG may be used to predict long term prognosis of HIE children.

摘要

未标记

为探讨振幅整合脑电图(aEEG)在新生儿缺氧缺血性脑病(HIE)早期诊断及长期预后预测中的价值,将120例HIE患儿随机分为aEEG组和对照组(每组n = 60)。每组患儿再分为轻度、中度和重度HIE组(每组n = 20)。aEEG组于出生后1、3、14和28天进行aEEG检查;两组均于出生后3、14和28天进行新生儿行为神经评定(NBNA)。出院患儿在矫正胎龄12个月时采用丹佛发育筛查试验(DDST)进行随访及预后评估。

结果

aEEG表现与HIE临床严重程度呈正相关(r = 0.843,P < 0.01)。第3天和第14天,两组NBNA评分相当(P > 0.05),但第28天NBNA评分有显著差异(P < 0.05)。第3天、第14天和第28天,aEEG表现与矫正胎龄12个月时的预后呈正相关(r = 0.832、0.857、0.778、0.743,P < 0.01)。aEEG组伤残率为13.8%,显著低于对照组(23.2%);aEEG组治愈率(60%)显著高于对照组(40%)。此外,aEEG组与对照组的长期预后也有显著差异(χ(2)=4.107,P < 0.05)。

结论

aEEG表现与HIE临床严重程度显著相关,可能有助于HIE的早期诊断。aEEG可用于预测HIE患儿的长期预后。

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